FDA Adverse Event Death Summary report: N

SIMPLEX BONE CEMENT

MDR report key: 2431569 · Received January 30, 2012

Report

Report Number
1818910-2012-02704
Event Type
Death
Date Received
January 30, 2012
Date of Event
May 31, 2011
Report Date
August 5, 2012
Manufacturer
DEPUY CMW
Product Code
LOD
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEPUY CONSIDERS THIS INVESTIGATION CLOSED. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION THAT CHANGES THIS CONCLUSION BE RECEIVED, THE INVESTIGATION WILL BE REOPENED.

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 1

DEPUY CONSIDERS THIS INVESTIGATION CLOSED. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION THAT CHANGES THIS CONCLUSION BE RECEIVED, THE INVESTIGATION WILL BE REOPENED.

Description of Event or Problem · 1

HAPPENED WHILE INSERTING THE FINAL FEMORAL IMPLANT AFTER RETROGRADE CEMENT FILLING INTO THE FEMORAL CANAL. THE SURGEON CLAIMS THAT PATIENT'S DEATH HAPPENED FOLLOWING THE USE OF THE REPORTED PRODUCT.

Description of Event or Problem · 1

DURING INVESTIGATION FOUND THAT THE BONE CEMENT WAS MANUFACTURED BY OTHERS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SIMPLEX BONE CEMENT BONE CEMENT LOD DEPUY CMW UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Death